Table 1.
Baseline characteristics and outcomes of emergency medical services suspected stroke admissions.
| All patients (n = 916) | Admitted before training (n = 522) | Admitted after training (n = 394) | P-value | Referred by urban EMS (n = 500) | Referred by suburban EMS (n = 416) | P-value | |
|---|---|---|---|---|---|---|---|
| Median age, years (IQR) | 75 (66–82) | 74 (65–82) | 75 (66–82) | 0.596 | 75 (66–82) | 75 (65–82) | 0.340 |
| Female sex, n (%) | 502 (54.8) | 276 (52.9) | 226 (57.4) | 0.177 | 272 (54.4) | 230 (55.3) | 0.788 |
| Confirmed strokes, n (%) | 748 (81.7) | 412 (78.9) | 336 (85.3) | 417 (83.4) | 331 (79.6) | ||
| Ischemic stroke | 606 (66.2) | 339 (64.9) | 267 (67.8) | 0.371 | 335 (67.0) | 271 (65.1) | 0.555 |
| Hemorrhagic stroke | 86 (9.4) | 46 (8.8) | 40 (10.2) | 0.491 | 48 (9.6) | 38 (9.1) | 0.810 |
| ICH | 68 (7.4) | 37 (7.1) | 31 (7.9) | 0.656 | 38 (7.6) | 30 (7.2) | 0.823 |
| SAH | 18 (2.0) | 9 (1.7) | 9 (2.3) | 0.545 | 10 (2.0) | 8 (1.9) | 0.933 |
| Transient ischemic attack | 56 (6.1) | 27 (5.2) | 29 (7.4) | 0.171 | 34 (6.8) | 22 (5.3) | 0.342 |
| Stroke mimics, n (%) | 168 (24.8) | 110 (28.2) | 58 (20.2) | 0.017 | 83 (23.4) | 85 (26.3) | 0.388 |
| Stroke chameleons, n (%) | 239 (32.0) | 132 (32.0) | 107 (31.8) | 0.955 | 146 (35.0) | 93 (28.1) | 0.044 |
| Daily volume, median (IQR) | |||||||
| Stroke alerts | 2 (1-3) | 2 (1-3) | 3 (2-4) | 0.002 | 1 (0-2) | 1 (0-2) | 0.275 |
| Confirmed strokes | 2 (1-4) | 2 (1-3) | 3 (2-4) | <0.001 | 1 (1-2) | 1 (1-2) | 0.005 |
| Reperfusion of ischemic strokes, n (%) | 203 (33.5) | 126 (37.2) | 77 (28.8) | 110 (32.8) | 93 (34.3) | ||
| Not eligible | 403 (66.5) | 213 (62.8) | 190 (71.2) | 0.031 | 225 (67.2) | 178 (65.7) | 0.701 |
| IVT | 97 (16.0) | 54 (15.9) | 43 (16.1) | 0.953 | 59 (17.6) | 38 (14.0) | 0.231 |
| EVT | 86 (14.2) | 62 (18.3) | 24 (9.0) | 0.001 | 41 (12.2) | 45 (16.6) | 0.126 |
| Combined treatment | 20 (3.3) | 10 (2.9) | 10 (3.7) | 0.586 | 10 (3.0) | 10 (3.7) | 0.629 |
| Median timeliness metrics, min (IQR) | |||||||
| Onset-to-door† | 114 (75-198) | 119 (78-205) | 110 (74-196) | 0.606 | 93 (67-159) | 137 (89-269) | <0.001 |
| Door-to-needle | 41 (29-59) | 41.5 (31-58) | 41 (29-60) | 0.850 | 46 (31-63) | 37.5 (28-51) | 0.078 |
| Door-to-groin | 81.5 (61-102) | 73.5 (61-100) | 90 (65-110) | 0.206 | 88 (60-107) | 78 (61-98) | 0.517 |
| Baseline NIHSS, median (IQR)‡ | 8 (4–15) | 9 (5–15) | 7 (4–15) | 0.072 | 8 (4–15) | 8 (5–15) | 0.643 |
| Discharge NIHSS, median (IQR)‡ | 3 (1–5) | 3 (1–5) | 3 (1–5) | 0.962 | 3 (1–4) | 3 (1–5) | 0.360 |
IQR, interquartile range; ICH, intracerebral hemorrhage; SAH, subarachnoid hemorrhage; IVT, intravenous thrombolysis; EVT, endovascular treatment; NIHSS, National Institutes of Health Stroke Scale.
†Only patients with established onset of symptoms are included (n = 433).
‡Baseline (n = 343) and discharge NIHSS (n = 172) are reported only for ischemic stroke patients who were considered for reperfusion therapy.